A hammer toe, hammertoe or contracted toe is a

deformity A deformity, dysmorphism, or dysmorphic feature is a major abnormality of an organism that makes a part of the body appear or function differently than how it is supposed to. Causes Deformity can be caused by a variety of factors: *Arthritis a ...

of the

muscle Muscle is a soft tissue, one of the four basic types of animal tissue. There are three types of muscle tissue in vertebrates: skeletal muscle, cardiac muscle, and smooth muscle. Muscle tissue gives skeletal muscles the ability to muscle contra ...

s and

ligament A ligament is a type of fibrous connective tissue in the body that connects bones to other bones. It also connects flight feathers to bones, in dinosaurs and birds. All 30,000 species of amniotes (land animals with internal bones) have liga ...

s of the

proximal Standard anatomical terms of location are used to describe unambiguously the anatomy of humans and other animals. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position prov ...

interphalangeal joint of the second, third, fourth, or fifth toe, bending it into a shape resembling a

hammer A hammer is a tool, most often a hand tool, consisting of a weighted "head" fixed to a long handle that is swung to deliver an impact to a small area of an object. This can be, for example, to drive nail (fastener), nails into wood, to sh ...

. In the early stage, a flexible hammertoe is movable at the joints; a rigid hammertoe joint cannot be moved and usually requires surgery. Reviewed March 31, 2019 Mallet toe is a similar condition affecting the

distal Standard anatomical terms of location are used to describe unambiguously the anatomy of humans and other animals. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position provi ...

interphalangeal joint. Claw toe is another similar condition, with

dorsiflexion Motion, the process of movement, is described using specific anatomical terms. Motion includes movement of organs, joints, limbs, and specific sections of the body. The terminology used describes this motion according to its direction relativ ...

of the proximal phalanx on the lesser

metatarsophalangeal joint The metatarsophalangeal joints (MTP joints) are the joints between the metatarsal bones of the foot and the proximal bones (proximal phalanges) of the toes. They are analogous to the knuckles of the hand, and are consequently known as toe knuckles ...

, combined with

flexion Motion, the process of movement, is described using specific anatomical terminology, anatomical terms. Motion includes movement of Organ (anatomy), organs, joints, Limb (anatomy), limbs, and specific sections of the body. The terminology used de ...

of both the proximal and distal interphalangeal joints. Claw toe can affect the second, third, fourth, or fifth toes.

Types

There are three types of hammer toe, as categorized by

podiatrist A podiatrist ( ) is a medical professional devoted to the treatment of disorders of the foot, ankle, and related structures of the leg. The term originated in North America but has now become the accepted term in the English-speaking world for ...

s. *Flexible hammer toes are where patients are still able to bend and move the affected toes, but where a noticeable curl has begun to form. *Semi-rigid hammer toes are where the affected toes are hard to bend and are noticeably stiff. *Rigid hammer toes are frozen in a curled position. These are most likely to require surgery.

Risk factors

Older people are more likely to develop hammer toes. Women are at higher risk, due to the construction of women's shoes. Injuries to the toes, and being born with a big toe that is short in comparison to the second toe, increase risk.

Arthritis Arthritis is a general medical term used to describe a disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth, Joint effusion, swelling, and decreased range of motion of ...

and

diabetes Diabetes mellitus, commonly known as diabetes, is a group of common endocrine diseases characterized by sustained high blood sugar levels. Diabetes is due to either the pancreas not producing enough of the hormone insulin, or the cells of th ...

may also increase the risk of foot deformities.

Causes

Hammertoes and clawtoes have multiple causes. Hammer toe most frequently results from wearing poorly fitting

shoe A shoe is an item of footwear intended to protect and comfort the human foot. Though the human foot can adapt to varied terrains and climate conditions, it is vulnerable, and shoes provide protection. Form was originally tied to function, but ...

s that can force the toe into a bent position, such as

high heels High-heeled shoes, also known as high heels (colloquially shortened to heels), are a type of shoe with an upward-angled sole. The heel in such shoes is raised above the ball of the foot. High heels cause the legs to appear longer, make the we ...

or shoes that are too short or narrow for the foot. Having the toes bent for long periods of time can cause the muscles in them to shorten, resulting in the hammer toe deformity. This is often found in conjunction with

bunion A bunion, also known as hallux valgus, is a deformity of the metatarsophalangeal joint, MTP joint connecting the big toe to the foot. The big toe often bends towards the other toes and the joint becomes red and painful. The onset of bunions is ...

s or other foot problems (e.g., a bunion can force the big toe to turn inward and push the other toes). The toe muscles work in pairs; if the muscles pulling in one direction are much weaker than those pulling in the other direction, the imbalance can bend the toe. If the bend persists, then as the tendons and ligaments tighten (as they do if not stretched), the bend may become permanent. Ill-fitting shoes are especially likely to push the toes out of balance. Toe deformities can also be caused by muscle, nerve, or joint damage, resulting from conditions such as

osteoarthritis Osteoarthritis is a type of degenerative joint disease that results from breakdown of articular cartilage, joint cartilage and underlying bone. A form of arthritis, it is believed to be the fourth leading cause of disability in the world, affect ...

rheumatoid arthritis Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects synovial joint, joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and h ...

stroke Stroke is a medical condition in which poor cerebral circulation, blood flow to a part of the brain causes cell death. There are two main types of stroke: brain ischemia, ischemic, due to lack of blood flow, and intracranial hemorrhage, hemor ...

, Charcot–Marie–Tooth disease,

complex regional pain syndrome Complex regional pain syndrome (CRPS type 1 and type 2), sometimes referred to by the hyponyms reflex sympathetic dystrophy (RSD) or reflex neurovascular dystrophy (RND), is a rare and severe form of neuroinflammatory and dysautonomic disorder ...

. Hammer toe can also be found in

Friedreich's ataxia Friedreich's ataxia (FRDA) is a rare, inherited, autosomal recessive neurodegenerative disorder that primarily affects the nervous system, causing progressive damage to the spinal cord, peripheral nerves, and cerebellum, leading to impaired ...

(GAA trinucleotide repeat). Kamran Jamshidinia MD Hammertoe Surgery

Treatment

In many cases, conservative treatment consisting of

physical therapy Physical therapy (PT), also known as physiotherapy, is a healthcare profession, as well as the care provided by physical therapists who promote, maintain, or restore health through patient education, physical intervention, disease preventio ...

and new shoes with soft, spacious

toe box The toe box is the section of footwear that surrounds the toes on closed-toe shoes. Toe boxes that are too tight can cause injuries and foot deformity, foot deformities, whereas wider toe boxes may be used to treat or prevent common foot condition ...

es is enough to resolve the condition, while in more severe or longstanding cases hammertoe surgery may be necessary to correct the deformity. The patient's doctor may also prescribe some toe exercises that can be done at home to stretch and strengthen the muscles. For example, the individual can gently stretch the toes manually, or use the toes to pick things up off the floor.

References

External links

Hammer Toe – American Academy of Orthopedic Surgeons

Hammer Toes – American Podiatric Medical Association

{{Congenital malformations and deformations of musculoskeletal system Arthropathies Congenital disorders of musculoskeletal system